Headache after epidural analgesia or a spinal anaesthetic

This leaflet describes a special type of headache that can occur after having an epidural or a spinal anaesthetic. You have been given this leaflet either because you already have a headache or because we believe you are at higher risk of developing one.

What is special about the headache?

Headaches can be common after childbirth. However, after having an epidural or spinal, you have a 1 in 100 (1%) chance of developing a ‘post dural puncture’ headache.

This typically occurs between one day and one week after having an epidural. It is usually a severe headache (felt at the front or back of your head) which gets better when lying down and worse on sitting or standing. Along with the headache you may experience neck pain or stiffness, sickness, changes in your hearing or vision, and a dislike of bright lights.

‘...it was like the worst hangover in the world…’

If you have had a spinal anaesthetic, the headache tends to be less severe.

What is an epidural blood patch?

Being given a blood patch is like having an epidural and takes about half an hour. The anaesthetist will take some blood from a vein in your arm and inject it into your back near the hole in the dura where it will clot. This will tend to plug the hole and help the hole to heal.

In 60-70% of cases, a blood patch will cure the headache within 24 hours. After this period if you still have a headache, or if the headache returns, it may be worth repeating the blood patch once more. It is very rare to need more than two blood patches. Your anaesthetist will discuss this with you.

After a blood patch, we recommend that you lie flat in bed for two hours and do not lift anything heavy for at least two days.

You may need someone at home with you to help you with your daily activities, and you should continue with regular simple pain relief The Anaesthetic team will continue to follow you up via telephone and they will contact your GP to make sure they are aware you have had an epidural blood patch.

There are alternative treatments, but none has been shown to be as effective as an epidural blood patch. You can discuss this with your anaesthetist.

This leaflet explains the causes, symptoms and treatment of the headache.

Your anaesthetist will be happy to discuss this in greater detail and to answer any questions that you have.